Pulmonary hypertension and cardiac hypertrophy in children recipients of orthotopic living related liver transplantation
Surgical stress, liberation of cytokines associated with re-perfusion injury, and long standing use of immune suppressive medications in children recipients of orthotopic living related liver transplantation (OLRLT) pose cardiovascular risk. Reported cardiovascular adverse effects vary from left ven...
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doaj-cec799f960084812a334400a8a5080ef2020-11-24T22:57:59ZengElsevierJournal of Advanced Research2090-12322090-12242017-11-018666366810.1016/j.jare.2017.07.004Pulmonary hypertension and cardiac hypertrophy in children recipients of orthotopic living related liver transplantationMagd A. Kotb0Inas Abd El Satar1Ahmed M. Badr2Nancy H. Anis3Hoda Abd El Rahman Ismail4Alaa F. Hamza5Hesham M. Abdelkader6Department of Pediatrics, Faculty of Medicine, Cairo University, P.O. Box: 11461, Cairo, EgyptDepartment of Pediatrics, Faculty of Medicine, Cairo University, P.O. Box: 11461, Cairo, EgyptDepartment of Pediatrics, Faculty of Medicine, Cairo University, P.O. Box: 11461, Cairo, EgyptGhamra Military Hospital, P.O. Box: 11674, Cairo, EgyptPediatrics Liver Transplantation Division, Wadi El Nil Hospital, P.O. Box: 11527, Cairo, EgyptPediatric Surgery Department, Ain Shams University, P.O. Box: 11588, Cairo, EgyptPediatric Surgery Department, Ain Shams University, P.O. Box: 11588, Cairo, EgyptSurgical stress, liberation of cytokines associated with re-perfusion injury, and long standing use of immune suppressive medications in children recipients of orthotopic living related liver transplantation (OLRLT) pose cardiovascular risk. Reported cardiovascular adverse effects vary from left ventricular wall thickening, hypertrophic cardiomyopathy to resting ECG abnormalities, asymptomatic ST depression following increased heart rate and ventricular arrhythmias. Twenty-five consecutive children recipients of OLRLT were assessed by conventional 2-D, M-mode echocardiography and Doppler. The mean age ± SD at transplantation and at enrollment in study was 6.3 ± 4.5 and 13.5 ± 5.6 years respectively. All children were on immunosuppressive medications, with tacrolimus being constant among all. Long-term post-transplant echocardiography revealed statistically significant interventricular septal hypertrophy among all (mean thickness 0.89 ± 0.16 cm), (P = 0.0001) in comparison to reference range for age, 24 had pulmonary hypertension (mean mPAP 36.43 ± 5.60 mm Hg, P = 0.0001), and early diastolic dysfunction with a mean Tei index of 0.40 ± 0.10. However cardiac function was generally preserved. Children recipients of OLRLT have cardiac structural and functional abnormalities that can be asymptomatic. Pulmonary hypertension, increased cardiac mass, de novo aortic stenosis and diastolic heart failure were among abnormalities encountered in the studied population. Echocardiography is indispensible in follow-up of children recipients of OLRLT.http://www.sciencedirect.com/science/article/pii/S2090123217300942Children pediatricOrthotopic living related liver transplantationCardiovascular complications adverse eventsLeft ventricular hypertrophy cardiomyopathy pulmonary hypertensionImmunosuppressive medicationsTacrolimus |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Magd A. Kotb Inas Abd El Satar Ahmed M. Badr Nancy H. Anis Hoda Abd El Rahman Ismail Alaa F. Hamza Hesham M. Abdelkader |
spellingShingle |
Magd A. Kotb Inas Abd El Satar Ahmed M. Badr Nancy H. Anis Hoda Abd El Rahman Ismail Alaa F. Hamza Hesham M. Abdelkader Pulmonary hypertension and cardiac hypertrophy in children recipients of orthotopic living related liver transplantation Journal of Advanced Research Children pediatric Orthotopic living related liver transplantation Cardiovascular complications adverse events Left ventricular hypertrophy cardiomyopathy pulmonary hypertension Immunosuppressive medications Tacrolimus |
author_facet |
Magd A. Kotb Inas Abd El Satar Ahmed M. Badr Nancy H. Anis Hoda Abd El Rahman Ismail Alaa F. Hamza Hesham M. Abdelkader |
author_sort |
Magd A. Kotb |
title |
Pulmonary hypertension and cardiac hypertrophy in children recipients of orthotopic living related liver transplantation |
title_short |
Pulmonary hypertension and cardiac hypertrophy in children recipients of orthotopic living related liver transplantation |
title_full |
Pulmonary hypertension and cardiac hypertrophy in children recipients of orthotopic living related liver transplantation |
title_fullStr |
Pulmonary hypertension and cardiac hypertrophy in children recipients of orthotopic living related liver transplantation |
title_full_unstemmed |
Pulmonary hypertension and cardiac hypertrophy in children recipients of orthotopic living related liver transplantation |
title_sort |
pulmonary hypertension and cardiac hypertrophy in children recipients of orthotopic living related liver transplantation |
publisher |
Elsevier |
series |
Journal of Advanced Research |
issn |
2090-1232 2090-1224 |
publishDate |
2017-11-01 |
description |
Surgical stress, liberation of cytokines associated with re-perfusion injury, and long standing use of immune suppressive medications in children recipients of orthotopic living related liver transplantation (OLRLT) pose cardiovascular risk. Reported cardiovascular adverse effects vary from left ventricular wall thickening, hypertrophic cardiomyopathy to resting ECG abnormalities, asymptomatic ST depression following increased heart rate and ventricular arrhythmias. Twenty-five consecutive children recipients of OLRLT were assessed by conventional 2-D, M-mode echocardiography and Doppler. The mean age ± SD at transplantation and at enrollment in study was 6.3 ± 4.5 and 13.5 ± 5.6 years respectively. All children were on immunosuppressive medications, with tacrolimus being constant among all. Long-term post-transplant echocardiography revealed statistically significant interventricular septal hypertrophy among all (mean thickness 0.89 ± 0.16 cm), (P = 0.0001) in comparison to reference range for age, 24 had pulmonary hypertension (mean mPAP 36.43 ± 5.60 mm Hg, P = 0.0001), and early diastolic dysfunction with a mean Tei index of 0.40 ± 0.10. However cardiac function was generally preserved. Children recipients of OLRLT have cardiac structural and functional abnormalities that can be asymptomatic. Pulmonary hypertension, increased cardiac mass, de novo aortic stenosis and diastolic heart failure were among abnormalities encountered in the studied population. Echocardiography is indispensible in follow-up of children recipients of OLRLT. |
topic |
Children pediatric Orthotopic living related liver transplantation Cardiovascular complications adverse events Left ventricular hypertrophy cardiomyopathy pulmonary hypertension Immunosuppressive medications Tacrolimus |
url |
http://www.sciencedirect.com/science/article/pii/S2090123217300942 |
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